The buzz on brittle bones

  By Dr. Ivan Olegario

With more and more people reaching the ripe old age, diseases such as osteoporosis are becoming increasingly prevalent. Take care of your bone health now before you become another statistic.

Osteo-what?
Osteoporosis is a condition where the bones become so thin and weak you run the risk of fractures. Bone is a living tissue that grows in a porous, mesh-like structure. Throughout life, the body breaks down old bone and rebuilds new bone in a continuous cycle. You should gain more bones than you lose, but when it is the other way around, you become a candidate for osteoporosis.

Building bones requires several components:

• The minerals, calcium and phosphorus, when combined, form the "cement" of the bone.
• The protein called collagen acts as steel reinforcements to the brittle cement.
• Vitamin D stimulates absorption of calcium.
• Hormones, estrogen in women and testosterone in men, signal special bone cells to build bone.
• Physical activity can also be a stimulus to deposit more cement and reinforcement into the bone.

The major problem with aging-related osteoporosis (found typically among perimenopausal women) is a lack of hormones—the materials are there, but there are no orders to build.

Osteoporosis affects more than half of women and a third of men over 60 years old, as well as a few younger people.

The big deal
Thin bones, per se, do not cause problems. It’s when they break that the real trouble begins. Osteoporosis is debilitating as it can lead to fractures in the spine, wrists, hips and other bones. Coughing lightly or lifting a bag of groceries may cause fractures in osteoporotic bones.

A broken wrist can lead to difficulties in dressing, housekeeping, gardening, and doing other activities. Worse, a broken hip or spine can land you in a wheelchair.

Osteoporosis is often called the "silent disease" because you may not know you have thin bones until they break. So the best way to avoid osteoporosis is by preventing bone thinning and fractures.

Bone up early!
To prevent osteoporosis, make sure your bones are thick. And the best time to thicken your bones is during childhood, when bone growth is at its peak. Children, adolescents and adults should heed these tips:

• Take enough calcium from supplements or calcium-rich foods (milk, milk products, green vegetables and fish [sardine] bones).
• Exercise regularly to stimulate bone growth.
• Get adequate sunlight (five to 10 minutes a day), and vitamin D supplements, especially if the child is not a hearty eater.
• Avoid cigarette smoke, caffeine (coffee and colas), and regular heavy alcohol drinking.

Break a leg!
Adults need to go one step further by checking for osteoporosis or osteopenia (early signs of bone thinning), and preventing injuries that can lead to fractures.

To find out if you have osteoporosis, know your bone density through a test called a DEXA scan. Take this scan if you have these risk factors:

• Age 50 years or older
• Thin, petite frame
• Fair skin
• Menopause
• Had surgical removal of ovaries
• Never been pregnant
• Unmeasured daily calcium intake
• Physical inactivity
• Drinking more than four standard alcoholic drinks per day
• Long-term use of steroids (e.g., cortisone, prednisone) or anticonvulsant drugs
• A family history of fractures in elderly relatives

Discuss the results of your scan with your doctor and ask for treatment options. Treatments range from calcium and vitamin D supplementation and hormone replacement therapy, to taking of bisphosphonates and other bone-specific medicines that increase bone density.

To reduce your risk of falls in day-to-day life:

• Plan your activities.
• Avoid straining your back or falling. Wear slip-proof shoes, put slip-proof mats in the bathroom, and hold on handrails.
• Be careful when lifting, bending or reaching.
• Use a cane or walker correctly and consistently, especially if you have poor balance.
• Have your eyesight checked to keep from bumping into things or slipping up.